Free Consumer Demographic Survey template by 123ContactForm

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Consumer Demographic Survey Thank you for joining our consumer demographic survey. Please give us your feedback by filling in the information below.
What is your gender?
Male Female

What is your age category?
Under 18 18-24 25-34 35-44 45-54 55-64 65 or Above

Do you support children under 18?
Yes No

If the answer is yes, please mention their number.


Which is your martial status?
Single, not married Married Living with partner Separated Divorced Widowed Prefer not to answer

Which is your employment status?
Employed full time Trade or Vocational degree Not employed, but looking for work Not employed and not looking for work Retired Student Homemaker Prefer not to answer

Choose your education level.
Some high school High school graduate or equivalent Trade or Vocational degree Some college Associate degree Bachelor's degree Graduate or professional degree Prefer not to answer

What state do you live in?


Select the range that includes your total yearly household income before taxes.
Under $20,000 $20,000 - $29,999 30,000 - $39,999 $40,000 - $49,999 $50,000 - $69,999 $70,000 - $99,999 $100,000 - $149,999 $150,000 or more Prefer not to answer

Verification No.